MEDICAL Get MORE with value med PRU Introduction: We all know just how crucial medical care is in today’s world and the need for healthcare becomes even more paramount as we age. With the escalating cost of healthcare, have you ever wondered if you are able to safeguard yourself against any uncertainty and insufficient savings for healthcare? Wouldn’t it be great if there is a medical plan that not only promises you a lifetime of assurance for all your medical needs, but also helps you save with more benefits? Introducing PRUvalue med, a medical plan that combines extraordinary values and savings. With PRUvalue med, you will never have to choose between your health and finances as your healthcare needs are what matters most to us. Get MORE with PRUvalue med. value med PRU offers you MORE Savings Med Saver MORE Coverage MORE value in every way MORE Benefits Med Value Point RM1.5 million 1st RM 1.5 million • 100% of the total claims will be paid by Prudential PRUvalue med 100% Non-Cancellable* Subsequent RM500k • 80% will be paid by Prudential • 20% will be borne by policyholder Total eligible claims RM2 million Day Care Procedure Save time & go home 11 Maternity Complication Benefits Outpatient Cancer & Kidney Treatment Take Home Drugs Consultation Fees Examination Test is the same as Guaranteed Renewable Emergency Treatment of Outpatient Injury Home Nursing Care Note: PRUvalue med is non-cancellable unless there is fraud or any circumstance that makes the policy or rider voidable or null and void. This depends on all premiums being paid duly and the policy or rider being in force. value med All about PRU What is PRUvalue med? PRUvalue med is a regular premium investment-linked medical rider that reimburses medical expenses incurred in the event of hospitalization and for outpatient treatment. What are the benefits provided under PRUvalue med? Benefit Benefit Amount Room & Board Benefits Descriptions a) Hospital Daily Room & Board (R&B) limit per day, up to 150 days per year Flexible option between RM100 and RM600 per day (Increments in multiples of RM100 per day) Hospital & Surgical Benefits ¹ b) Intensive Care Unit / Cardiac Care Unit c) In-hospital & Related Services • Surgical Benefit • Hospital Supplies and Services • Operating Theatre • Anaesthetist Fees • In-Hospital Specialist’s Visit Up to 90 days per year As Charged ² limit to 2 visits per day Outpatient Treatment Benefits ¹ d) Pre-hospitalisation Treatment e) Post-hospitalisation Treatment f) g) h) i) j) Home Nursing Care Day Surgery Day Care Procedure Outpatient Cancer Treatment Outpatient Kidney Dialysis within 60 days before hospitalisation within 90 days after hospital discharge 180 days per life-time including take home drugs, examination tests & consultation As Charged ² As Charged ² Up to 1.5 times of the chosen Med Value Point per lifetime value med All about PRU Benefit Benefit Amount Other Benefits k) Maternity Complications Benefit ¹ for female life assured l) Intraocular Lens m) Emergency Treatment For Accidental Injury¹ Med Value Point Up to RM5,000 per year Up to RM6,000 per lifetime Up to 10 times of Daily R&B amount per year Flexible option between RM1,000,000 and RM2,000,000 (Increments in multiples of RM500,000) Med Saver¹ Emergency Medical Assistance Yes / No Yes ¹ If Med Saver is chosen, policyholder must first pay a fixed amount of RM300 out of the total Reasonable and Customary Charges of eligible benefits (excluding the cost of Daily Room & Board and Intraocular Lens) for any one disability. If Med Saver is not chosen, the fixed amount of RM300 shall not apply. ² We shall only reimburse Reasonable and Customary charges on eligible expenses which are deemed Medically Necessary. Note: For Overseas Treatment, if the life assured chooses to have or is referred to be treated outside Malaysia, the benefits for the treatment is limited to the Reasonable and Customary and Medically Necessary charges for equivalent local treatment in Malaysia and subject to 90 days residence limit. value med All about PRU What is Med Value Point (MVP)? Claims on eligible benefits will be payable in full (subject to Med Saver, if applicable) up to the chosen Med Value Point. If the total claims exceed the chosen Med Value Point, we will still pay 80% of the total cost of the eligible benefit cost. Outpatient Cancer Treatment and Outpatient Kidney Dialysis Benefits will be up to 1.5 times of the chosen Med Value Point. Claims on Outpatient Cancer Treatment and Outpatient Kidney Dialysis Benefits will be counted as part of Med Value Point. MED VALUE POINT SCENARIO Mr.A age 35*, purchases PRUvalue med MVP Eligible Amout Claims : 1.5 million 1st 2nd 3rd 4th 5th 6th Expiry Age : 80 years old *Age next birthday 250k 300k 350k 500k 320k 280k Total Claims RM2 million of the total cost of the eligible benefits TIMELINE Expiry Age 1.5M Fully Paid by Prudential MVP 500K Continuous Coverage Up to Age 80 2060 2015 Policy Purchased Prudential still pays 80% 80% Prudential 20% Customer 400K 100K Note: The above examples are for illustrative purposes only and all benefits are subject to waiting periods. Please refer to the Policy Document for the detailed terms and conditions. value med All about PRU What is Med Saver? Med Saver allows you to enjoy premium savings where the premium saved can be used to enhance your coverage and retirement funds. If Med Saver is chosen, you must first pay a fixed amount of RM300 out of the eligible benefits before Prudential pays for any expenses for any one disability (Excluding the cost of Daily Room & Board and Intraocular Lens) How Med Saver works? ENJOY FURTHER MED SAVER PREMIUM SAVINGS How much do i save? Save up to RM6,482 per year Use the premium saved for other goals GET MORE SAVINGS GET MORE COVERAGE GET MORE Higher Cash Value Better Protection Better Medical Plan BENEFITS value med All about PRU MED SAVER Scenario James is a 35-year-old male customer working as an Accountant (Class 1). He had bought a PRUlink one with PRUvalue med on 1 April 2015 with yearly premium of RM5,250 invested in PRUlink equity fund and he would have the following options: RM1,221 PVM Without Med Saver (RM) PVM with Med Saver (RM) Annual Premium 5,250 Cash Value @ 65 years old* Death & TPD Critical Illnesses Med Value Point Room & Board Expiry Age Description Remarks Use Premium saved for other goals Investment Buy More Coverage Better Medical Plan 4,029 5,250 5,250 5,250 112,364 74,330 162,352 120,413 102,053 100,000 100,000 1 mil 300 80 100,000 100,000 1 mil 300 80 100,000 100,000 1 mil 300 80 150,000 150,000 1 mil 300 80 100,000 100,000 1.5 mil 400 80 - Saved RM1,221 per year Higher Cash Value Higher Coverage Note: * Illustration is based on a high projected investment return scenario (i.e., 9% p.a. for the first 20 years and 6% p.a. thereafter). The projected values are for illustrative purpose only. These values are neither guaranteed nor based on past performance of the investment-linked funds. value med All about PRU STEP 4 How do I get started with PRUvalue med? Decide on your Expiry Age STEP 3 Decide on your Hospital Daily Room & Board Amount STEP 2 Decide on your Med Saver Option STEP 1 80 Decide on your Med Value Point YES 1 1.5 2 70 NO 100 200 300 400 500 600 90 100 (RM, Million) (RM) (YEARS OLD) Who can take up the plan? PRUvalue med is available to anyone aged between 14 days to 70 years old on their next birthday. It is also available to pre-birth child from 18 weeks onwards with a waiting period of 30 days from the date of birth. Entry Age Next Birthday Expiry Age 70 90 100 14 days (prenatal is allowed to purchase) Min Max 80 60 70 How much premium do I have to pay? The total premium that you have to pay and the policy terms may vary depending on our underwriting requirements. You are given one month's grace period after the due date for the payment of premium. The premiums are payable throughout the duration of the plan up to the chosen expiry age. We will allocate a portion of the premium to purchase units in the investment-linked fund(s). Any unallocated amount will be used to pay commissions to agent/ wealth planner and other expenses by us. You are advised to refer to the allocation rates given in the sales illustration. `Premiums can be paid yearly, half-yearly, quarterly or monthly via Auto Debit, Credit card, Cash or Cheque. value med All about PRU What is non-cancellable? PRUvalue med is non-cancellable which also means PRUvalue med coverage is guaranteed unless there is fraud or any circumstance that makes the policy or PRUvalue med voidable or null and void. This depends on all premiums being duly paid and the policy or PRUvalue med being in force. What are the waiting periods that I should be aware of? Description Waiting Period from commencement date or date of revival Any Illnesses other than Specified Illnesses 30 days Specified Illnesses 120 days Maternity Complications 365 days Note: This list is non-exhaustive. Please refer to the Policy Document for the full list of terms and conditions under this product. What are the key terms and conditions that I should be aware of? 1. Importance of disclosure - when answering any question asked by us, you must disclose all relevant facts such as medical condition and state your age correctly. If the insurance policy is intended wholly for your personal purposes, you must take reasonable care to disclose any facts that you know to be relevant to us and not to mislead us. Your above duty of disclosure continues until the policy is issued. 2. Free-look period - you may cancel your policy by returning the policy within 15 days after the policy has been delivered to you. We will refund to you the unallocated premiums, the value of units that have been allocated (if any) at unit price at the next valuation date and any insurance charge and other charges that have been deducted less any medical fee incurred. 3. Cash value - the cash value of the policy depends on the performance of the investment-linked fund(s) invested. The higher the level of Insurance coverage selected, the more units will be absorbed to pay for the insurance charges and the fewer units will remain to accumulate cash values under your policy. You should consider whether the allocation of insurance premiums towards protection and investment meets your financial circumstances. 4. Policy lapse - The policy will lapse when the value of investment units is insufficient to pay for the insurance and other charges. Please note that this is an insurance product that is tied to the performance of the underlying assets, and is not a pure investment product such as unit trusts. Appendix Sample Annual Premium Rates for Male and Female with Med Value Point of RM1,000,000. (Occupational Class 1 & 2) Expiry Age 70 Med Saver Hospital Daily Room & Board (RM) With Med Saver 100 200 300 400 Without Med Saver 500 600 100 200 300 400 500 600 Entry Age Next Birthday 1-2 991 1,127 1,465 1,859 2,197 2,478 1,572 1,787 2,323 2,948 3,484 3,931 3 - 15 958 1,089 1,415 1,796 2,123 2,395 1,316 1,495 1,944 2,467 2,915 3,289 16 - 20 1,044 1,187 1,543 1,958 2,314 2,611 1,434 1,630 2,119 2,690 3,179 3,586 21 - 25 1,142 1,297 1,687 2,141 2,530 2,854 1,445 1,642 2,135 2,710 3,202 3,613 26 - 30 1,182 1,344 1,747 2,217 2,620 2,956 1,512 1,718 2,233 2,834 3,350 3,779 31 - 35 1,260 1,432 1,862 2,363 2,793 3,151 1,697 1,929 2,507 3,183 3,761 4,243 36 - 40 1,464 1,664 2,163 2,746 3,245 3,661 2,000 2,272 2,954 3,750 4,431 5,000 41 - 45 1,787 2,031 2,640 3,351 3,960 4,468 2,364 2,687 3,493 4,433 5,239 5,911 46 - 50 2,122 2,411 3,135 3,979 4,702 5,305 2,918 3,316 4,311 5,472 6,467 7,296 51 - 55 2,737 3,110 4,043 5,131 6,064 6,842 4,117 4,678 6,081 7,719 9,122 10,291 56 - 60 3,407 3,872 5,034 6,389 7,550 8,518 5,262 5,979 7,773 9,866 11,659 13,154 Expiry Age 80 Med Saver Hospital Daily Room & Board (RM) With Med Saver 100 200 Without Med Saver 300 400 500 600 100 200 300 400 500 600 Entry Age Next Birthday 1-2 1,267 1,440 1,872 2,376 2,808 3,168 1,746 1,984 2,580 3,274 3,869 4,366 3 - 15 1,267 1,440 1,872 2,376 2,808 3,168 1,746 1,984 2,580 3,274 3,869 4,366 16 - 20 1,410 1,603 2,083 2,644 3,125 3,526 1,944 2,209 2,872 3,645 4,308 4,860 21 - 25 1,576 1,791 2,329 2,955 3,493 3,941 2,039 2,317 3,012 3,823 4,518 5,098 26 - 30 1,632 1,854 2,410 3,059 3,615 4,079 2,173 2,470 3,211 4,075 4,816 5,433 31 - 35 1,744 1,982 2,576 3,270 3,864 4,360 2,491 2,831 3,680 4,671 5,520 6,228 36 - 40 2,017 2,292 2,979 3,781 4,469 5,042 2,912 3,309 4,302 5,460 6,453 7,280 41 - 45 2,523 2,867 3,727 4,730 5,590 6,307 3,467 3,940 5,122 6,501 7,683 8,668 46 - 50 3,072 3,491 4,539 5,760 6,808 7,681 4,308 4,895 6,364 8,077 9,545 10,769 51 - 55 4,086 4,643 6,036 7,662 9,055 10,216 5,850 6,647 8,641 10,968 12,962 14,624 56 - 60 5,064 5,755 7,481 9,495 11,222 12,660 7,241 8,228 10,696 13,576 16,045 18,102 61 - 65 6,099 6,931 9,010 11,436 13,515 15,248 8,692 9,877 12,841 16,298 19,261 21,730 66 - 70 7,723 8,776 11,409 14,481 17,114 19,308 10,226 11,621 15,107 19,174 22,660 25,565 Premium rates are based on standard risk and are subject to underwriting. Exclusions PRUvalue med does not cover any hospitalization, surgery or charges caused directly or indirectly, wholly or partly, by any one of the following occurrences: 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) 13) Pre-existing conditions. Specified Illnesses listed below occurring during the first 120 days from the commencement date of the rider, the date it is revived, whichever is later. (a) Hypertension, diabetes mellitus and Cardiovascular disease; (b) Growths of any kind including tumours, cancers, cysts, nodules, polyps; (c) Stones of the urinary system and biliary system; (d) Any disease of the ear, nose (including sinuses) or throat; (e) Hernias, haemorrhoids, fistulae, hydrocele or varicocele; (f) Any disease of the reproductive system including endometriosis; or (g) Any disorders of the spine (including a slipped disc) and knee conditions. Any medical or physical conditions and its signs or symptoms occurring within the first 30 days from the commencement date of the rider or the date it is revived, whichever is later, except for traumatic bodily injury caused by an accident. Any neonatal medical or physical conditions including birth trauma (a physical injury sustained by an infant during birth) occurring within the first 30 days from the commencement date of the rider, the date it is revived or the date of birth, whichever is latest. Plastic / Cosmetic surgery, hyperhidrosis, circumcision, eye examination for nearsightedness, farsightedness or astigmatism, visual aids and refraction or surgical correction of nearsightedness (Radial Keratotomy) and the use or acquisition of external prosthetic appliances or devices such as but not limited to artificial limbs, hearing aids, cochlear apparatus, external or temporary pacemakers and prescriptions thereof. Dental conditions including dental treatment or oral surgery except as necessitated by Accident to sound natural teeth occurring while the Policy and the rider are in force. Private nursing (except for Home Nursing Care Benefit), rest cures or sanitaria care. Drug abuse, under influence of alcohol, venereal disease and its sequelae, AIDS (Acquired Immune Deficiency Syndrome) or ARC (AIDS Related Complex) and HIV related diseases, and any communicable diseases required quarantine by law. Any treatment or surgical operation for congenital abnormalities or deformities including hereditary conditions. Pregnancy, child birth (including surgical delivery), miscarriage, abortion and prenatal or postnatal care and surgical, mechanical or chemical contraceptive methods of birth control or treatment pertaining to infertility and its complications, with exception to the benefits as provided under the Maternity Complications Benefits. Erectile dysfunction and tests or treatment related to impotence or sterilization. Primarily for investigatory purposes, diagnosis, X-ray examination, stem cell therapy, general physical or medical examinations, not incidental to treatment or diagnosis of a covered Disability or any treatment which is not Medically Necessary and any preventive treatments, preventive medicines or examinations carried out by a Physician, and treatments specifically for weight reduction or gain or bariatric surgery. Suicide, attempted suicide or intentionally self-inflicted injury while sane or insane. War or any act of war, declared or undeclared, criminal or terrorist activities, act of foreign enemies, active duty in any armed forces, direct participation in strikes, riots, civil commotion, insurrection, revolution or any war-like operations. Exclusions 14) Ionising radiation or contamination by radioactivity from any nuclear fuel or nuclear waste from process of nuclear fission or from any nuclear weapons material. 15) Expenses incurred for donation of any body parts or organ by a Life Assured and acquisition of the organ including all costs incurred by the donor during organ transplant and its complications. 16) Investigation and treatment of sleep apnoea and snoring disorders, hormone replacement therapy and alternative therapy such as treatment, medical service or supplies, including but not limited to chiropractic services, acupuncture, acupressure, reflexology, bonesetting, hyperbaric oxygen therapy, herbalist treatment, massage or aroma therapy or other alternative treatment. 17) Care or treatment for which payment is not required or to the extent which is payable by any other insurance or indemnity covering the Life Assured, and Disabilities arising out of duties of employment or profession that is covered under a Workman's Compensation Insurance Contract. 18) Psychotic, mental or nervous disorders (including any neuroses and their physiological or psychosomatic manifestations). 19) Costs / expenses of services of a non-medical nature, such as television, telephones, telex services, radios or similar facilities, admission kit/pack and other ineligible non-medical item. 20) Participating in racing of any kind (except foot racing), hazardous sports such as but not limited to skydiving, water skiing, underwater activities requiring breathing apparatus, winter sports, professional sports and illegal activities. 21) Private flying other than as a fare-paying passenger in any commercial scheduled airlines licensed to carry passengers over established routes. 22) Expenses incurred for sex changes. Note: This list is non-exhaustive. Please refer to the Policy Document for more details about the major exclusions under this policy. YOU SHOULD SATISFY YOURSELF THAT THIS PRODUCT WILL BEST SERVE YOUR NEEDS. YOU SHOULD READ AND UNDERSTAND THE INSURANCE POLICY AND DISCUSS WITH THE AGENT OR CONTACT THE INSURANCE COMPANY DIRECTLY FOR MORE INFORMATION. IT IS IMPORTANT THAT ANY RECEIPT THAT YOU RECEIVE SHOULD BE KEPT AS PROOF OF PAYMENT OF PREMIUMS. Important Notes • This brochure is for illustrative purposes only. You are advised to refer to the Product Disclosure Sheet and Sales Illustration before purchasing a plan, and to refer to the terms and conditions in the policy document for details of the important features of the plan. • You should assess the affordability and suitability of the product (including optional benefits) in relation to your financial goals and risk appetite. To achieve that, we recommend that you speak to your agent or Wealth Planner who will perform a needs analysis and assist you in making an informed decision. • You must inform us of any change in your occupation, avocation or sports activities because it may affect the premiums, terms, conditions and benefits. • PRUvalue med is guaranteed to be renewable but premium rates and / or insurance charges are NOT guaranteed. We reserve the right to revise the premium rates and / or insurance charges at policy anniversary by giving you a 30-day notice. • Coverage to expiry age is subject to sufficient funds for insurance charges and service charges. • Non-payment of premiums may cause your policy to cease. • There is a free-look period of 15 days after the delivery of your policy to allow you to review if it meets your needs. If the policy (which PRUvalue med is attached to) is cancelled within this period, the value of units (at next pricing day) plus the unallocated premiums, service charge, and insurance charges less medical expenses will be refunded. • If you cancel the policy (which PRUvalue med is attached to) in the early years, you may not be able to obtain the full value from the amount you have paid in. Upon surrender, the benefits under PRUvalue med will cease. • Prudential Assurance Malaysia Berhad (PAMB) is a licensed insurance company and is regulated by Bank Negara Malaysia. • PRUvalue med is not a Shariah Compliant product. Prudential Assurance Malaysia Berhad Member of PIDM Prudential Assurance Malaysia Berhad (PAMB) is a member of Perbadanan Insurans Deposit Malaysia (PIDM). As a member of PIDM, some of the benefits insured under the insurance policies offered by PAMB are protected against loss of part or all of insurance benefits by PIDM, in the unlikely event of an insurer member failure. For further details of the protection limits and the scope of coverage, please obtain a PIDM information brochure from PAMB or visit PIDM website (www.pidm.gov.my) or call PIDM toll free line (1-800-88-1266). This page is intentionally left blank. Prudential Assurance Malaysia Berhad (107655-U) Tel: 03-2116 0228 Fax: 03-2032 3939 Email: [email protected] www.prudential.com.my 04/2015 Menara Prudential, 10 Jalan Sultan Ismail, 50250 Kuala Lumpur, Malaysia.
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